Abstract

Injection drug use is associated with several public health issues, primarily the spread of serious blood-borne diseases such as human immunodeficiency virus (HIV) and hepatitis C virus (HCV). Injections drug users often participate in risky behaviors such as the sharing of drug paraphernalia. Blood-borne diseases such as HIV and HCV are very easily transmitted between injection drug users through shared drug paraphernalia. In the United States, over one million people are infected with HIV, and one third of these infections are related to injection drug use in some manner. There are many traditional interventions and programs currently being implemented in an attempt to address the public health issues associated with injection drug use; however, a controversial intervention focused on harm reduction is the focus of this paper. Safe injection facilities are relatively new interventions aimed at reaching high-risk injection drug users. These facilities provide a safe place in which injection drug users can take their own drugs and inject them under the supervision of medical staff. The benefits of this type of intervention are many. Injection drug users are able to inject in a safe environment in which they do not feel rushed, easy access to clean drug paraphernalia to use for injections, and trained medical staff are able to respond to overdose situations in a rapid manner. Safe injection facilities have an excellent record of reducing overdose deaths, in some cases to zero. There is potential for safe injection facilities to be of great public health significance in helping to control the spread of diseases and improving the quality of life for drug users. Safe injection facilities are common in Europe, but are viewed with great hesitation and concern in North America and some other countries. This paper is a critical review of the literature, examining studies conducted on the various issues surrounding safe injection facilities, and their potential role as an important public health intervention.